Splitting: It’s Not Just for Borderline Personality - Psychology Today

Splitting is defined as:

A mental mechanism in which the self or others are viewed as all good or all bad, with failure to integrate the positive and negative qualities of the self and others into cohesive images. Often, the person alternately overidealizes and devalues the same person (Shahrokh & Hale, 2003).

The gifted psychoanalyst Nancy McWilliams, (2013), noted that splitting is used in everyday adult life. She explained it is "a powerful and appealing way" to make sense of complex/confusing/threatening experiences in everyday adult life, such as the free world against terrorists or good versus evil.

Source: Robin Higgins/Pixabay

Nonetheless, the term "splitting" may send shivers up your spine. Images flash of patients with character pathology, constantly pitting staff or family members against one another in order to attain some goal. You sprout a thought bubble with "borderline" pulsating in neon red to a nuclear danger alarm sound.

Such a Pavlovian response is premature.

A Condemning Assumption

As written about in Tips for Accurate Diagnosing: 1 Symptom isn't Enough, too frequently a well-known core feature of a diagnosis isn't contextualized and the diagnosis it is most associated with is applied to the person. We must remember the edict of Emil Kraepelin, the father of modern psychiatric diagnosis who said, "A single symptom, however characteristic as may be, never justifies a diagnosis by itself…" (Spitzer et al., 2002).

While people with borderline personality disorder (BPD) are well-known to engage in splitting, assuming a person has BPD based on this alone is damaging.

BPD is indeed a vexing diagnosis, and popular culture misunderstandings, like it being synonymous with Glenn Close's character in Fatal Attraction, make it perhaps the most stigmatized mental illness (Knaack et al., 2015; Ring & Lawn, 2018). Unfortunately, even clinicians, particularly new clinicians who have no other point of reference, can succumb to these misunderstandings because personality disorders get little attention in academic programs. As soon as it is proposed someone has BPD, they may, for example, be avoided because of the assumed difficulty they'll present, and thus not be provided the attention they deserve.

Splitting Activity Must Be Contextualized

It's not always pathological or diagnostic. For someone in a correctional institution, what seems like splitting may just be going from one person to another trying to get a need met. They're in a setting where looking out for number one counts, and needs get met any way possible. If that means playing staff, you do what you must do, like if a kid doesn't get what they want from one parent, they go to another. It doesn't mean the child will grow up to have BPD.

For splitting to be pathological, and thus a sign of character disturbance, it must be an established pattern within a bigger clinical picture.

It isn't unusual for someone to be entirely fed up with a family member they previously got along with and see them as all negative in family or couples work. They may be moody towards them and even seem to feel rejected two major Borderline traits. However, suppose the person doesn't have a history of such behavior and a general background of a tumultuous relationship. In that case, chances are it's isolated to the family member and not a BPD issue.

It must also be considered that pathological splitting can be evidence of diagnoses other than personality disorders. For example,

I once evaluated a young adult who exhibited mounting evidence of maturing BPD. They cast themselves as victim, mostly regarding their immediate family, and sought savior figures; there were push-pull dynamics, explosive reactions to limit setting, and self-destructive behaviors. However, there was no developmental history of traumas, abandonment or parental BPD modeling, as usually seen in BPD backgrounds.

THE BASICS

Source: Geralt/Pixabay

Interestingly, the victimization material was increasingly unusual. Upon evaluation, it was discovered that beliefs about their family that led to "borderline" reactions were part of a billowing persecutorial delusion that the family didn't like them. In times of clarity, they were loving and peacefully relating, as if nothing ever changed, only to be swallowed again by the delusion, telling everyone who'd listen how they were ousted and harassed by the family. Coupled with increasingly disorganized activity and unprovoked self-dialogue, it was clear this was evolving psychosis and not likely BPD.

Evaluating for Personality-Based Pathological Splitting

The first example of personality-based pathological splitting I witnessed was so distinct that no other metaphor than "black and white" thinking could describe it. An inmate demanded to be seen after a call with his girlfriend. Typically idealizing her, that day, he was irate about her. She was unable to visit, and he assumed she was lying. "If she does come around, I'm going to make her feel so small she'll need a stepladder to get over a curb!" he literally cried.

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The next week, he explained, matter-of-factly, that she came to visit, brought one of his Italian suits for his court date, and talked about how much he appreciated her. Over time, I was subjected to similar changes in status. He sometimes refused to see anyone but me and, were I not immediately available, would later let me know just where I stood.

For those who have never encountered such dynamics, similar examples can be seen throughout the 1945 film Mildred Pierce, as Mildred's daughter, Veda, like a see-saw, overidealizes and undervalues Mildred and Monte.

If the tendency is to assume BPD if you perceive someone splitting, take a step back and consider the following:

• Is the behavior an established pattern of obvious over-idealization and undervaluation as in the above examples or is it isolated to one incident or person?
• Can it be recognized as an ongoing, general manner of interpersonal relation causing social/familial strain?
• Is it part of a larger clinical pathology that includes fears of abandonment, self-destructive behaviors, and intense, reactive moods?
• Is it possible the splitting is occurring during a psychotic disorder or affective disorder episode?

If the above can't be established, such an arbitrary application of this diagnosis only serves to protect the clinician while damning the patient, and this begs the question, who's really doing the splitting?

Disclaimer: The material provided in this post is for informational purposes only and not intended to diagnose, treat, or prevent any illness in readers. The information should not replace personalized care from your provider or formal supervision if you're a practitioner or student.

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